Fine-Needle Aspiration-Based Patient-Derived Cancer Organoids.

Fine needle aspiration biopsy and flow cytometry in the diagnosis of lymphoma

Fine needle aspiration biopsy (FNAB) is a simple yet accurate diagnostic procedure. However, the role of FNAB in lymphoma diagnosis and classification remains controversial. This study aimed to evaluate the value of FNAB cell blocks in the diagnosis and classification of lymphoma using our patented aspirator in a pencil-grip operation manner and a simplified cell block preparation method. We retrospectively reviewed 177 cases of lymph node and extranodal lymphoproliferative disorders that were diagnosed with cytomorphology, morphology, and immunohistochemistry of cell blocks. Of these, 83 were primary lymphoma; 14 were recurrent lymphoma; 8 were suspected as lymphoma, and 72 were benign reactive hyperplasia (BRH). Our analysis indicated 99.0% sensitivity, 95.9% specificity, 97.1% positive predictive value, and 98.6% negative predictive value in discriminating among primary/recurrent lymphoma and BRH. The diagnostic accuracy for sub-classification of lymphoma was 86.6% (84/97), with 77.8% (7/9) for classical Hodgkin’s lymphoma and 87.5% (77/88) for non-Hodgkin’s lymphoma. Our results implicated cell blocks as a reliable and useful adjunct to FNAB for the diagnosis and classification of lymphoma. Cytomorphology, morphology, and immunohistochemical studies of cell blocks offered very high accuracy in the diagnosis of lymphoma and allowed further sub-classification in many cases. Thus, patients with a definitive diagnosis and classification might avoid invasive and expensive surgical biopsy procedures.

Value of fine needle aspiration cell blocks in the diagnosis and classification of lymphoma.

We retrospectively studied the use of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) as a tool for the diagnosis of deep-seated lymphoma. An on-site assessment at the time of EUS-FNAB was performed by a cytopathologist using Diff-Quik (American Scientific Products, McGraw Park, IL) stain. In addition, Papanicolaou stains were performed on EUS-FNAB smears, immunohistochemical stains were performed on cell blocks, and additional samples were sent for flow cytometric analysis. Final cytologic diagnosis was correlated with surgical pathology and/or clinical follow-up. We evaluated EUS-FNAB specimens of deep-seated lymph nodes, spleen, stomach, and pancreas, and 1 EUS-guided needle core biopsy specimen of a lymph node. Thirteen cases of deep-seated lymphoma were diagnosed, including non-Hodgkin lymphomas and Hodgkin lymphoma. One case of hairy cell leukemia was diagnosed. EUS-FNAB is a minimally invasive, cost-effective, and useful tool for the primary diagnosis or staging of deep-seated lymphomas.

/pdf/diagnosis-of-deep-seated-lymphoma-and-leukemia-by-endoscopic-3dngtvr4b1.pdf

Diagnosis of deep-seated lymphoma and leukemia by endoscopic ultrasound-guided fine-needle aspiration biopsy.

Background: We retrospectively studied 1338 samples of lymph nodes obtained by endoscopic and endobronchial ultrasound-guided fine needle aspiration biopsy (EUS and EBUS-FNAB) with an objective of characterizing the utility of this diagnostic modality in the assessment of deep-seated lymphadenopathy. The secondary aims were to establish the utility in the diagnosis of lymphoma and to determine the number of passes required to obtain adequate cellularity for flow cytometric analysis. Materials and Methods: On-site assessment was performed by a cytopathologist using Diff-Quik (American Scientific Products, McGraw Park, IL) stain. In addition, Papanicolaou and immunohistochemical stains were performed and additional samples were sent for flow cytometric analyses (n = 145). The final cytologic diagnosis was correlated with surgical pathology diagnosis and/or clinical follow-up. In select cases, fluorescence in situ hybridization analysis with specific probes was performed on Diff-Quik smears. Results: Both morphology as well as ancillary studies (flow cytometry or immunohistochemical stain and/or fluorescence in situ hybridization) show that EUS and EBUS-FNA are effective techniques to detect and stage intrathoracic and intra-abdominal tumors. Operating characteristics show that these are highly sensitive (89%) and specific (100%) techniques for the diagnosis of lymphoma. At least two passes provided an average of 5.66 million cells (range, 0.12-62.32 million) for lymphoma cases. Conclusions: EUS and EBUS-FNA are powerful modalities to stage malignancies and at least two passes can provide adequate cells for flow cytometric analysis. We also demonstrate that fluorescence in situ hybridization analysis can be performed on Diff-Quik-stained and mounted smears.

Endoscopic ultrasound and endobronchial ultrasound-guided fine-needle aspiration of deep-seated lymphadenopathy: Analysis of 1338 cases.

Fine needle aspiration is a feasible and accurate technique in the diagnosis of lymphoma.

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Fine needle aspiration is a feasible and accurate technique in the diagnosis of lymphoma.